Background older adults living in long-term care (LTC) commonly suffer from anxiety symptoms and disorders. We completed a systematic review and meta-analysis to identify efficacious treatments for anxiety symptoms for older adults living in LTC. Methods we searched five electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials) to identify treatments for anxiety that have been trialled in LTC. Included studies had to be randomised trials, include residents of LTC, and measure anxiety symptoms as an outcome. Results the electronic search returned 6,617 articles, 519 were reviewed in full text, and 80 were included in the descriptive synthesis. Limited studies were meta-analysed (n = 10) due to differences in described treatment and comparator conditions. Limited clinically relevant evidence supporting the use of pharmacologic treatments for symptoms of anxiety in LTC was identified. Of the treatments trialled, music compared with usual care (standardised mean difference, SMD: −0.82; 95% confidence interval (CI): −1.31, −0.34), music compared with social interaction (SMD: −0.41; 95% CI: −0.72, −0.10) and massage compared with usual care (SMD: −4.32; 95% CI: −7.44, −1.19) were found to improve anxiety symptoms, however, significant heterogeneity was detected in two comparisons. Conclusions a range of non-pharmacologic treatments that improved anxiety symptoms were identified for use in LTC. Although limited evidence exists to support the use of particular treatments, most non-pharmacologic treatments were low-risk interventions that may be readily implemented. Further research is required to assess the treatment effect on residents of LTC with anxiety disorders or clinically relevant symptoms at baseline.

中文翻译：

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长期护理中焦虑症的非药物和药物治疗：系统评价和荟萃分析

背景 生活在长期护理 (LTC) 中的老年人通常患有焦虑症状和障碍。我们完成了系统回顾和荟萃分析，以确定生活在 LTC 中的老年人焦虑症状的有效治疗方法。方法 我们搜索了五个电子数据库（MEDLINE、Embase、PsycINFO、Cochrane 系统评价数据库和 Cochrane 对照试验中央登记册），以确定已在 LTC 中试验过的焦虑治疗方法。纳入的研究必须是随机试验，包括 LTC 的居民，并将焦虑症状作为结果进行测量。结果 电子检索返回 6,617 篇文章，其中 519 篇被全文审查，80 篇被纳入描述性综合。由于所描述的治疗和比较条件的差异，对有限的研究进行了荟萃分析（n = 10）。确定了支持对 LTC 焦虑症状使用药物治疗的有限临床相关证据。在试验的治疗中，音乐与常规护理相比（标准化平均差，SMD：-0.82；95% 置信区间 (CI)：-1.31，-0.34），音乐与社交互动相比（SMD：-0.41；95% CI： −0.72，−0.10) 和按摩与常规护理相比（SMD：−4.32；95% CI：−7.44，−1.19）被发现可以改善焦虑症状，但是，在两项比较中发现了显着的异质性。结论 确定了一系列可改善焦虑症状的非药物治疗用于 LTC。尽管支持使用特定治疗的证据有限，但大多数非药物治疗都是低风险的干预措施，可以很容易地实施。